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IDENTIFICATION — To be completed by all applicants Name Mailing address - Number, street, city, and State ZIP code Tel. No. Owner or ///ice <�A�Pi[e Ca:1).rKt�f 7 fis7//C�A'i�C� 5 r f/t�+��vtP H/�. l�o bU-/75c/ Lessee // / 2. �Te�4— lO✓S'T. �o �/ o ftS'7F/fC�, �� 7, c)/3-3 U Licenser No. d412S-0 Contractor 3. Architect or Engineer I hereby certify that the proposed work is authorized by the owner of record and that I have been authorized by the owner to make this application as his authorized agent and we agree to conform to all applicable laws of this jurisdiction. Signature of applicant Address Application date 00 NOT WRITE BELOW THIS LINE V. PLAN REVIEW RECORD — For office use Plans Review Required Check Plan Review Date Plans B Date Plans B Notes Fee Started y Approved y BUILDING $ PLUMBING $ MECHANICAL $ ELECTRICAL Is OTHER Is VI. ADDITIONAL PERMITS REQUIRED OR OTHER JURISDICTION APPROVALS Permit or Approva I Check Date Number By Permit or Approval Check Date Number B Obtained Obtained By BOILER PLUMBING CURB OR SIDEWALK CUT ROOFING ELEVATOR SEWER ELECTRICAL SIGN OR BILLBOARD FURNACE STREET GRADES GRADING USE OF PUBLIC AREAS OIL BURNER WRECKING OTHER OTHER VII. VALIDATION Building FOR DEPARTMENT USE ONLY Permit number Building n 2 Use Group Permit issued 19$ Building Fire Grading Permit Fee $ t4d` Live Loading Certificate of Occupancy $ Occupancy Load Approved by: Drain Tile $ Plan Review Fee $ TITLE CITY OF NORTHAMPTON MASSACHUSETTS $ OFFICE of the INSPECTOR of BUILDINGS �T Page _)C11 Plot : APPLICATION FOR ZONING PERMIT AND INSPECTOR BUILDING PERMIT z IMPORTANT — Applicant to complete all ,itte�m C) -s in sections: 1, 11, 111, IV, and IX. L 7 ,41Art Fc7 ��� D ZONING STN CT LOCATION I• AT (LOCATION)_ �/ N(p"O•) L (STREET) LO BETWEEN /V ,) �/a (-Ioc ST AND BUILDING (CROSS STREET) (CROSS STREET) LOT SUBDIVISION. LOT BLOCK SIZE to II. TYPE AND COST OF BUILDING — All applicants complete Parts A — D A. TYPE OF IMPROVEMENT D. PROPOSED USE - For"Wrecking" most recent use m 1 ❑ New building Residential Nonresidential 2 ❑ Addition(l/ residential, enter number 12 Z One family 18 ❑ Amusement, recreational of new bousing units added, if any, in Part D, 13) 13 F-1 Two or more family - Enter 19 L❑ Church, other religious number of units- - - - 20 L❑ Industrial 3 © Alteration (See 2 above) 14 ❑ Transient hotel, motel, 21 parking garage 4 ❑ Repair, replacement or dormitory - Enter number 5 ❑ Wrecking (11 multifamily residential, of units ------- - -i 22 L� Service station, repair garage enter number of units in building to 15 ❑ Garage 23 L❑ Hospital, institutional Part D, 13) 24 ❑ Office, bank, professional 6 Moving (relocatiot) 16 ❑ Carport ❑ 25 ❑ Public utility 17 ❑ Other - Specify 7 ❑ Foundation only 26 L❑ School, library, other educational B. OWNERSHIP 27 ❑ Stores, mercantile 8 ® Private(individual, corporation, 28 ❑ Tanks, towers nonprofit institutian, etc.) 29❑ Other - Specify 9 ❑ Public(Federal, `.hate, or local government) C. COST (Omit cents) Nonresidential - Describe in detail proposed use of buildings, e.g., food �0 processing plant, machine shop, laundry building at hospital, elementary 10. Cost of improvement... „........... qr��o'- school, secondary school, college, parochial school, parking garage for. department store, rental office building, office building at industrial plant. To be installed but not included OO If use of existing building is being changed, enter proposed use. in the above cost / 7 5_0 a. Electrical..... ................ t 2 Z� aoo b. Plumbing .... ................ Jr c. Heating, air conditioning.......... d. Other (elevator, etc.)............. / 11. TOTAL COST OF IMPROVEMENT $ /0,6,50 III. SELECTED CHARACTERISTICS OF BUILDING — For new buildings and additions, complete Parts E — L,- for wrecking, complete only Part J, for all others skip to IV. E. PRINCIPAL TYPE OF: FRAME G. TYPE OF SEWAGE DISPOSAL J. DIMENSIONS Z 48. Number of stories......... 30❑ Masonry (wall bearing) 40 a Public or private company 31 Wood frame 41 ❑ Private (septic tank, etc.) 49. Total square feet of floor area, all floors, based on exterior X00 32 ❑ Structural steel dimensions ..................... 33 ❑ Reinforced concrete H. TYPE OF WATER SUPPLY 34 El Other - Specify 42 ❑ Public or private company 50. Total land ores, sq. ft. ........... 43 ❑ Private (well, cistern) K. NUMBER OF OFF-STREET PARKING SPACES 51. Enclosed ....................... F. PRINCIPAL TYPE OF HEATING FUEL I. TYPE OF MECHANICAL Z 35 ❑ Gas Will there be central air 52. Outdoors........................ 36 Oil conditioning? L. RESIDENTIAL BUILDINGS ONLY 37 ❑ Electricity 44 [❑ Yes 45 No 53. Number of bedrooms.............. 38 ❑ Coal 39 ❑� Other - Specify Will there be an elevator? Full.......... - 54. Number of 46 l r, Yes 47 � No bathrooms - Partial....... a DEPT. OF BUILDING INSPECTIONS BUILDING z -'//o , e) ! 212 Main Street Oa Northampton, MA 01060 PERMIT 17C - 172 VALIDATION DATE 1c1PaUlC-y 29, 19 527_ PERMIT NO. APPLICANT ^Dgl o�g rn�wctj QP _ _ ADDRESS D (1 Rnv NT �Shf i nl d- 4a S. 6 (N0.1 ( T E7 (CONTR'S LICENSE) OF PERMIT TO 3W91�- (_) STORY One Family NUMBERNG UNITS MPROVEMENT) N0. (PROPOSED USE) 27 Fairfield Ave. ZONING U B AT (LOCATION) DISTRICT (NO.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO 8E FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: permit for theremodeling of existing kitchen and new 1/2 bath AREA OR 10,650.00 FEEMIT s 40.00 VOLUME 1 .600 sQ. ft• ESTIMATED COST (CUBIC/SQUARE FEET) /,, .. OWNER Paul & Patrice Goldman ADDRESS 23XXXX 27 Fairfield Ave. , Florence, Mass. 01060 BY WHITE - FILE COPY . GREEN ^ FIELD COPY • CANARY - APPLICANT COPY • PINK ASSESSORS COPY p6 P